MBP-Positive and CD11c-Positive Cells Are Associated with Different Phenotypes of Korean Patients with Non-Asthmatic Chronic Rhinosinusitis

Background
Asthmatic nasal polyps primarily exhibit eosinophilic infiltration. However, the identities of the immune cells that infiltrate non-asthmatic nasal polyps remain unclear. Thus, we thought to investigate the distribution of innate immune cells and its clinical relevance in non-asthmatic chronic rhinosinusitis (CRS) in Korea.
Methods
Tissues from uncinate process (UP) were obtained from controls (n = 18) and CRS without nasal polyps (CRSsNP, n = 45). Nasal polyps (NP) and UP were obtained from CRS with nasal polyps (CRSwNP, n = 56). The innate immune cells was evaluated by immunohistochemistry such as, eosinophil major basic protein (MBP), tryptase, CD68, CD163, CD11c, 2D7, human neutrophil elastase (HNE) and its distribution was analyzed according to clinical parameters.
Results
In comparisons between UP from each group, CRSwNP had a higher number of MPB+, CD68+, and CD11c+ cells relative to CRSsNP. Comparisons between UP and NP from CRSwNP indicated that NP have a higher infiltrate of MBP+, CD163+, CD11c+, 2D7+ and HNE+ cells, whereas fewer CD68+ cells were found in NP. In addition, MBP+ and CD11c+ cells were increased from UP of CRSsNP, to UP of CRSwNP, and to NP of CRSwNP. Moreover, in UP from CRSwNP, the number of MBP+ and CD11c+ cells positively correlated with CT scores. In the analysis of CRSwNP phenotype, allergic eosinophilic polyps had a higher number of MBP+, tryptase+, CD11c+, 2D7+ cells than others, whereas allergic non-eosinophilic polyps showed mainly infiltration of HNE+ and 2D7+ cells.
Conclusions
The infiltration of MBP+ and CD11c+ innate immune cells show a significant association with phenotype and disease extent of CRS and allergic status also may influences cellular phenotype in non-asthmatic CRSwNP in Korea.

### 研究背景
哮喘性鼻息肉主要表现为嗜酸性粒细胞浸润。然而，非哮喘性鼻息肉的浸润免疫细胞类型仍不明确。因此，本研究旨在探究韩国人群中非哮喘性慢性鼻-鼻窦炎（chronic rhinosinusitis, CRS）患者先天免疫细胞的分布特征及其临床相关性。

### 研究方法
本研究从对照组（n=18）、无鼻息肉慢性鼻-鼻窦炎（CRSsNP, n=45）患者中获取钩突（uncinate process, UP）组织；从伴鼻息肉慢性鼻-鼻窦炎（CRSwNP, n=56）患者中获取鼻息肉（nasal polyps, NP）及钩突组织。采用免疫组织化学法检测先天免疫细胞标志物，包括嗜酸性粒细胞主要碱性蛋白（eosinophil major basic protein, MBP）、类胰蛋白酶（tryptase）、CD68、CD163、CD11c、2D7、人中性粒细胞弹性蛋白酶（human neutrophil elastase, HNE），并根据临床参数分析细胞分布情况。

### 研究结果
三组钩突组织对比显示，伴鼻息肉慢性鼻-鼻窦炎（CRSwNP）组的MBP+、CD68+及CD11c+细胞数量均高于无鼻息肉慢性鼻-鼻窦炎（CRSsNP）组。CRSwNP患者的钩突与鼻息肉组织对比显示，鼻息肉组织中MBP+、CD163+、CD11c+、2D7+及HNE+细胞浸润程度更高，而CD68+细胞数量更少。此外，MBP+与CD11c+细胞数量从CRSsNP组钩突、依次升高至CRSwNP组钩突，再至CRSwNP组鼻息肉组织。进一步分析显示，CRSwNP组患者的钩突组织中，MBP+与CD11c+细胞数量与CT评分呈正相关。在CRSwNP表型分析中，变应性嗜酸性鼻息肉患者的MBP+、类胰蛋白酶+、CD11c+及2D7+细胞数量均高于其他表型患者，而变应性非嗜酸性鼻息肉患者主要表现为HNE+与2D7+细胞浸润。

### 研究结论
MBP+与CD11c+先天免疫细胞的浸润程度与慢性鼻-鼻窦炎（CRS）的表型及疾病严重程度显著相关；变应性状态也可能影响韩国人群中非哮喘性伴鼻息肉慢性鼻-鼻窦炎（CRSwNP）患者的细胞表型。